1. I wish to apply for admission to the IOMIT's SSR Medical College, Mauritius and hereby declare that the above information is true and complete to the best of my knowledge. I am aware that if any information herein is found to be incorrect or in complete, my application will be rejected & admission will be cancelled.

2. lf admitted to SSR Medical College, I shall abide by its rules and regulations.

3. I have read and understood all the provisions contained in the prospectus and here by agree to abide by these provisions

4. l. The parent/guardian of the applicant hereby declare that I am aware of the financial obligations of admitting my son/daughter/ward to SSR Medical College. I agree to pay the tuition and other fees payable to the institution as fixed by tne IOMIT from time to time. I also affirm and endorse the declaration made above by my son/daughter/ward

5. I agree that registration of this application does not confer any right on me in respect of selection for admission, which is solely left to the discretion of the institution.

DATE:-

PAYABLE AT MAURITIUS IN THE NAME OF "INDIAN OCEAN MEDICAL INSTITUTE TRUST,